Archive for November 16th, 2010|Daily archive page

Table manners

On two recent occasions, I’ve been at the Alz center during mealtime. I no longer time my visits to end when a meal begins. It’s pretty easy to say goodbye to Mom now. Between her fixation on Mr. R and her general happiness, she has been quite content to bid me farewell when I have announced it’s time for me to go. So being there when the food arrived became a new experience again – because of the way Mom treats her food now.

I can’t recall now why I was there a few weeks ago when her lunch arrived. I think it was the week leading up to the failed dermatologist appointment, when I was in the center on four days in a row. The lunch on this day was salisbury steak, potatoes and gravy, and some sort of vegetable. When the tray was placed in front of Mom, she picked up the steak – which was covered with gravy – with her hand and took a bite out of it. And then she placed it on the table beside her tray, as if to set it aside briefly while she tended to other things. I encouraged her to use a fork. But it didn’t have much meaning to her. She eventually picked up the steak with her hand and took another bite. She would sort of twitch her hands over the tray, as if the sight of everything was a little confusing. But once she had located food, she knew it went in her mouth. I left before she finished. And I felt a little sad at this obvious sign of decline.

I was there again on a Sunday afternoon, at a time that I thought would be following lunch. This was the day Ed was visiting from Cleveland. I arrived early to see if I could locate shoes for Mom. It was about 12:45, so I assume Mom had finished her lunch when I found her sitting with Mr. R. But I learned that Mom apparently had rejected the notion of lunch, as had Mr. R, before I got there. So when I arrived, a staff member tried again to give Mom a tray. Mom sat down at the table, studied the tray, and picked up the small plate with a piece of chocolate cream pie on it. She used her fingers to dig into the top of the pie and put the creamy contents into her mouth. She took a few bites that way before putting down the plate. The rest of her lunch was the kind of food she likes – turkey and mashed potatoes with gravy. I cut up the turkey with her fork and suggested she try using it to take some bites. She did use the fork briefly. But her heart didn’t seem really in it this time. A man at the table tried to converse with us, which was distracting but also pleasant – Mom seemed to enjoy him despite the fact that what they said to each other didn’t make much sense. I eventually left Mom at the table and went looking for Ed in the parking lot. When I came back, Mom’s plate was very unattractive, as if she had stirred her food. I guess she didn’t have much of an appetite that day.

My neighbor, a hospice social worker, told me recently that she sees Mom almost every day because she has so many patients at the center. She said it looks like Mom has lost some weight. I hope that doesn’t mean Mom is not eating. I assume I would get a call if the staff became seriously concerned. I haven’t seen Mom in about 12 days. I visited her on the day I left for a conference, and I’ve been a little sick since I got back. That was a really pleasant visit. There was a man playing guitar and singing old songs, and the residents were seated in a circle around him. I sat beside Mom and we swayed to the music, clapped our hands and just enjoyed ourselves. She would occasionally know a word or two, such as “Don’t sit under the apple tree with anyone else but me.” At one point, the activities director came over and jokingly asked Mom who that pretty girl was sitting beside her. And Mom looked over to me, and seemed surprised to see me there. That is how fast the forgetting can happen.

I’m thinking about the eating thing because Patrick and I will be having Thanksgiving dinner with Mom at the Alz center this Thursday, a week before the actual holiday. It will be interesting to see how Mom does with her food. When I spoke about the changes in her eating habits at support group, the doctor who runs the meetings noted that the norms associated with polite eating aren’t really important for Alzheimer’s patients. And I agree – I don’t care that Mom appears to be impolite or childlike. I don’t care about that AT ALL. I’m relieved that she still knows that food goes in her mouth, and that she still finds chocolate cream pie enticing. But to see her eat with her fingers, and to not recognize how to use utensils, is such a clear indication that physical functions are slipping along with her mental function. I have no delusions about how this is going to turn out. But I still don’t like bearing witness to these inevitable losses.

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